Congress report - European Health Forum Gastein

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European Health Forum Gastein 2001
trading in community time has been one particularly effective and now widespread
phenomena.”
Tessa Jowell MP, as Minister for Education and Employment, March 2001
This briefing provides an introduction to how community time banks – the social
infrastructure known as ‘time dollars’ in the USA – can be adapted successfully in the health
sector, to keep people healthy, to speed up recovery and to save scarce NHS resources. It is
intended to do two things:
• Introduce the concept of community time banks as a health regeneration tool.
• Provide a brief summary of the first evaluation of a time bank used in a GP’s
surgery at Rushey Green in Lewisham.
The evaluation is part of a much more comprehensive three-year project involving Guy’s,
King’s and St Thomas’ hospitals – carried out by the Socio-Medical Research Centre at St
Thomas’ Hospital – which will not report for some time. It was carried out by one of the
doctors at the practice, Dr Isobel Garcia, and will be published in full shortly.
Background
‘Time dollars’ or community time banks are the brainchild of Washington law professor Edgar
Cahn, who developed them as a way of providing non-medical services for older people –
helping them to stay in the own homes, keep hospital appointments and stay healthy.
Supported from 1986 by the Robert Wood Johnson Foundation, the first wave of time dollar
schemes in the USA a new kind of money, known in the UK as ‘time credits.’ These are now
used in over 200 cities in the USA to fuel volunteer schemes, health maintenance
programmes, support old people and a range of other local social projects. There are around
700 similar schemes in Japan, backed by the government, and more in China – both places
with high proportions of older people in the population.
Community time bank schemes work by measuring and rewarding the time people spend
helping each other in their local communities. Everyone’s time is worth the same and the
time credits earned can have their value underpinned by local authorities or concerned
businesses making goods available in return for them – reinforcing reciprocity and trust. But
even without that, time banks are one way of putting neighbours in touch with each other,
using people’s skills and imagination – particularly older people’s time, which is ignored by
the market economy – and building a network of neighbourhood support.
Evaluation conducted by the University of Maryland’s Centre on Ageing throughout the 1990s
established that time banks were able to attract people who don’t normally volunteer, keep
old people healthier and cut drop-out of volunteers. 1 Most dramatically, the hospital group
Sentara, in Richmond, Virginia, found that using a time bank to provide peer support for
people with asthma, cut emergency admissions to hospital by 74 per cent and saved
$217,000 over two years. 2
One of the most successful projects in the USA, is Elderplan, a social Health Maintenance
Organisation in New York City. In their first 12 years, mutual volunteers from their Member to
Member project have put in over 100,000 hours helping each other, teaching each other and
supporting each other to be independent. Member to Member enables volunteers to earn
1
Robert Wood Johnson Foundation (1990): Service Credit Banking Project Site Summaries, University of
Maryland Centre on Aging, Baltimore.
2
Time Dollar Institute (1999): Angels and Health: Time dollars and healthcare, Time Dollar Institute,
Washington DC.
International Forum Gastein, Tauernplatz 1, A-5630 Bad Hofgastein
Tel.: +43 (6432) 7110-70, Fax: Ext. 71, e-mail: info@ehfg.org, website: www.ehfg.org